Childhood obesity is a prominent public health issue. Obese children are more likely to have risk factors for cardiovascular disease, including high blood pressure and high cholesterol. They are also at increased risk for Type 2 diabetes, sleep apnea, asthma, joint and musculoskeletal issues, fatty liver disease, gallstones, gastro-esophageal reflux and early puberty. Obese children are more likely to be obese adults and continue to be at risk for these conditions, as well as stroke, osteoarthritis and certain types of cancer.
Obese children are also more at risk for social and psychological challenges, which can last into adulthood. Weight bias, or the inclination to form unreasonable judgments based on a person’s weight, has been on the rise and can lead to teasing and discrimination in multiple venues, including home, school, health care settings and the workplace. Although it would be better if such attitudes did not exist, the unfortunate current reality is that obese individuals do encounter weight bias.
Although many people acknowledge that it’s important to address, multiple studies have shown that parents of overweight and obese children often misperceive their child’s weight status. Some reported rates of incorrect perception have been over 90 percent, and it occurs across gender, race/ethnicity, socioeconomic status and region of the country. A recent study showed that this tendency to misperceive weight status by parents of obese preschool children has increased over the past two decades.
Knowing whether your child is overweight or obese is important because it has implications for their present and future health. Cognizant parents can be active in advocating for their child and trying to prevent the negative consequences that come from prejudices.
A Weighty Matter
If childhood obesity and its consequences are so important, then why is it so difficult to talk about? There is no doubt that weight is a sensitive topic. Based on previous research, parents want the issue to be raised by their medical provider, even if it is not the primary reason for their medical visit. Myself and a colleague, Dr. Elissa Gross, recently conducted a survey where we work at the Children’s Hospital at Montefiore in the Bronx (which has disproportionately high childhood obesity rates), and responses showed that this holds true even for parents of children who have been hospitalized for an acute illness, not their weight.
However, prior studies have shown that parental perception of weight discussions with medical providers is affected by the language and terminology used and whether parents feel they are being blamed or judged for their child’s weight. In turn, medical providers are hesitant to raise the issue due to concerns that it might not be well received and could diminish previously established trust. All of this ultimately results in silence when dialogue is required to increase awareness of an issue with significant repercussions on a child’s health. Ongoing conversation is also essential in empowering and supporting parents and children to make positive lifestyle changes.
Young children have limited control over factors that can contribute to weight status, like the types of food that are available to them. Parental recognition of a child’s weight status and family lifestyle habits therefore become essential to implementing healthy changes for young children. And despite increasing independence and more time away from home with age, parents can still influence their older child’s choices. Being a good role model, providing consistent routines surrounding family meals and physical activity, and setting limits are crucial parental actions in the effort to reduce and prevent childhood obesity.
Perhaps what is needed most is acknowledgment from both parents and medical providers that this is a difficult topic for everyone involved. Parents can help their doctors by telling them what language makes them feel uncomfortable and by proposing terms that they would prefer to be used instead. If a change is recommended that is not workable for your family, please speak up. Otherwise, your doctor will not know and cannot offer other suggestions that might be more feasible. Doctors can help by asking parents about their preferred terminology, their understanding of the issue and how it might impact their child and what changes they are able and ready to make.
There must be a measure of grace from both sides — from parents when a doctor says something that may sound insensitive or judgmental, and from doctors when it seems like their advice is going unheeded. Know that we will all make mistakes, expect that there will be times when the interaction will be uncomfortable, and be ready to continue to engage in spite of these barriers. Only when the conversation happens, is ongoing and is bi-directional can we help children achieve and sustain better health.
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Do You Recognize if Your Child is Overweight? originally appeared on usnews.com
